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Examining the Relation Between Anxiety, Depression, and Psychological Flexibility in Female Bhutanese Refugees. Sheau-Yan Ho University of Vermont ACBS World Conference 12 June 20, 2014. Bhutanese Refugees 101. Lhotsampas = “Southerners” of Nepal descent
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Examining the Relation Between Anxiety, Depression, and Psychological Flexibility in Female Bhutanese Refugees Sheau-Yan Ho University of Vermont ACBS World Conference 12 June 20, 2014
Bhutanese Refugees 101 • Lhotsampas = “Southerners” of Nepal descent • Late 1980s: “One Nation, One People” policy • Over 100,000 Lhotsampas were persecuted and expelled • Resettled in refugee camps in Nepal for 18+ years
Bhutanese Refugees 101 • Over 75,000 Bhutanese refugees have since arrived in the U.S. • In Vermont alone, over 800 Bhutanese families have re-settled • Present with a host of psychological difficulties associated with post-migration stressors (e.g., employment, housing/food, language barrier, discrimination, lack of social support)
Adjustment Group Therapy Structure • Group started in August 2013 • Facilitated by pre-doctoral clinicians • Conducted in English with Nepali interpreters • Weekly 2-hour meetings in community space • Open “drop-in” group format
Group Structure: Demographics Bhutanese women (N = 13) M age = 45.54 yrs (SD = 9.05) Marital status: 69% Married, 15% Widowed, 15% Single Religion: 77% Hindu, 15% Christian, 8% Buddhist Uneducated; unemployed or on disability Torture survivors: 54% M duration in U.S. = 2.67 yrs (SD = 1.37)
Group Therapy: Topics ACT Framework • Goals of therapy • Acculturation • Access to resources • Coping skills • Values work • Living with chronic pain • Communication in healthy relationships
Measures • Harvard Trauma Questionnaire • PTSD • Hopkins Symptom Checklist-25 • Anxiety • Depression • Acceptance and Action Questionnaire – II • Psychological Flexibility
Descriptives & Correlations Between Study Variables HSCL = Hopkins Symptom Checklist (Depression, Anxiety) HTQ = Harvard Trauma Questionnaire (PTSD) AAQ = Acceptance and Action Questionnaire (Psychological Flexibility) *p < .05, **p < .01
Simple Regression Analyses Predicting Psychological Flexibility in ACT Group
Summary • First study to examine psychological flexibility as a process mechanism in a group format ACT intervention for Bhutanese refugees • Trend toward significance indicating that higher levels of baseline post-traumatic stress symptoms were associated with lower levels of psychological flexibility at mid-treatment.
Future Directions • Growing sample size • Multiple time points • Examine other potential therapeutic processes